Objectives: To estimate the projected budgetary impact of adopting selinexor use in the intended patient population from the perspective of a third-party payer (private payer or Medicare) in the US.
Methods: A budget impact analysis was conducted in one-year increments for the first 3 years after the introduction of selinexor as a treatment for eligible patients with penta-refractory MM. The number of eligible patients was derived from the incidence of MM reported in US epidemiology statistics from multiple sources. Total annual treatment costs were calculated as the sum of drug costs, best supportive care costs, and costs of treating serious adverse events (grade 3 or higher). Dosing, duration of treatment, and rates of adverse events were obtained from the prescribing information for selinexor.
Results: In a hypothetical private payer plan with one million members, annual number of selinexor eligible patients was estimated to be 4. In the base-case analysis, the introduction of selinexor was associated with a limited budget impact with a per member per month (PMPM) cost of $0.0103 in year 3, assuming a market uptake of 64%. The budget impact remained modest in a scenario analysis in which the selinexor eligible population included patients with triple-class refractory MM regardless of the number of prior lines of therapy with an estimated PMPM cost of $0.0388. The model showed comparable sensitivity to treatment duration, wholesale acquisition cost for selinexor, and year 1 uptake, when base-case inputs were varied by ±10%. Model results for a hypothetical medicare plan was also associated with a limited budget impact.
Conclusions: With limited treatment options in the later lines, newly developed drug Selinexor in combination with dexamethasone for the treatment of multiple myeloma will have a small BI for a US health plan.
